UK Royal College of Nursing Calls for Free Heroin

The call for heroin assisted treatment (HAT) around the world is growing stronger every year. As more and more evidence is brought forward showing the clear advantages for longer term addicts, the more that it becomes accepted. Even the public are warming to the idea. Of course, the big question is whether Australia will follow the lead from other successful countries or continue with it's nondescript anti-drug campaign.

If you're listening Kev and Nic ... it's time to follow the evidence.

Prescribe Heroin on NHS, says Royal College of Nursing leader

The Times 

By David Rose, Health Correspondent

April 26, 2010

Heroin should be routinely prescribed on the NHS as a way of weaning drug users off their addiction, the head of the country’s top nursing union has said.

Peter Carter, the general secretary of the Royal College of Nursing (RCN), also said he was in favour of “drug consumption rooms” to enable addicts to take drugs safely under medical supervision, and to cut rates of drug-related crime.

Nurses gathering at the RCN’s annual congress in Bournemouth had earlier discussed providing heroin to addicts where other attempts at treatment have failed.

Results of pilot studies in London, Brighton and Darlington suggest that allowing users to inject themselves with the Class A drug under medical supervision can cut local crime rates by two-thirds over six months. Aberdeen has been considered as a potential future pilot location in Scotland.

But some experts are concerned at the prospect of providing legitimate “shooting galleries” in publically-funded clinics, despite the increasing use of methadone, the heroin-subsitute, and a lack of abstinence-based programmes.

Amid controversy over how to treat chronic drug users, members of the RCN, the country’s largest nursing union, discussed the possibility of providing heroin on the NHS today but did not hold a vote for or against the move.

Speaking in a personal capacity after the debate, Dr Carter, the former head of Central and North West London Mental Health NHS Trust, said that he believed in providing drugs, needle exchanges and locations for users to inject substances safely.

“The fact is heroin is very addictive,” he said. “People who are addicted so often resort to crime, to steal to buy the heroin. It obviates the need for them to steal.

“It might take a few years but I think people will understand that if you are going to get people off heroin then in the initial stages we have to have proper heroin prescribing services.” Dr Carter added that more research was needed into consumption rooms, which have been tested in Sydney and Amsterdam.

Experts found the programme stopped users injecting in school playgrounds and stairwells.

“Critics say you are encouraging drug addiction but the reality is that these people are addicts and they are going to do it anyway,” he added.

Radical proposals for the most chronic drug users were first advocated in 2002 by the then Home Secretary David Blunkett. The gave rise to pilot programmes in England in which users inject themselves with pharmaceutical diamorphine imported from Switzerland, under medical supervision.

Preliminary results suggest that of 127 users involved in the pilots, three-quarters “substantially reduced” their use of street drugs, while their spending on drugs fell from £300 to £50 a week. The number of crimes they committed also fell from 1,731 in three months to 547 in six months.

Delegates at the RCN congress Claire Topham-Brown, a nurse from Cambridgeshire proposed the motion for today’s debate, saying that that medical heroin could be provided as a means of “harm-reduction” which despite initial resistance by health professionals, “has now become an accepted model of practice”.

But some nurses disagreed. Gayle Brooks, of the union’s UK safety representatives committee, said: “Where would this stop, cannabis, cocaine, crack cocaine and other illicit substances? If we do this for heroin, do we have to do this for other substances, and can the NHS afford this?”

All three main political parties in Britain have stressed the importance of alternative treatments for long-term drug addicts in the run-up to the election.

While the number of heroin addicts needing treatment has decreased in recent years, almost 200,000 people receive methadone each year.

Recent guidance from the Department of Health made clear that prisoners serving sentences of more than six months should be encouraged to become “drug-free” — of prescribed and illegal substances — while in jail.

The Times has highlighted concerns about numbers who may emerge from the criminal justice system with an addiction to methadone; almost 20,000 inmates were put on the drug last year, a rise of 57 per cent since 2008.

Harry Shapiro, a spokesman for the charity Drugscope, said it would support moves towards “a balanced treatment system, with a range of different treatment options”, including providing heroin for a minority of users who met strict criteria for treatment.

“These are people who have been using for a long time and where previous attempts including rehabilitation had failed,” he added. “The results can be encouraging in that this can help people engage in treatment and control their chaotic lives.”

Doctors could regularly prescribe reduced heroin and cocaine to recovering drug addicts until 1968, when the practise required a Home Office license.

Dr Neil McKechnie, of Glasgow University, said any national programme to increase heroin provision on the NHS was “an extraordinary risky proposal”. “Where it is tightly controlled and prescribed to a very small group of addicts — 1 per cent of users — there may be some who can benefit, but we should be wary of a creeping extension of this, as happened with methadone.

“The vast majority of people on methadone are continuing to use illegal drugs, and by definition they are failing on their treatment.

“Most people would say that treatment for drug addiction is about getting people off drugs rather than giving them easy access to drugs.”

Full results from the pilots, overseen by the National Addiction Centre at King’s College London, will be published with the next couple of months.